Top Things to Know: Guidelines for the Prevention of Stroke in Women

Published: February 06, 2014

  1. More than 53% of the 795,000 strokes that occur in the US each year are in women.
  2. 6.8 million people are living with stroke, including more women than men (3.8 million women vs. 3.0 million men).
  3. Stroke is the 3rd leading cause of death in women, while stroke is the 4th leading cause of death overall.
  4. This Guideline points out that hypertension is a growing concern in the population of younger women and is a potent risk factor for stroke.
  5. This Guideline recommends that women be screened for high blood pressure before starting birth control pills because the combination increases stroke risk.
  6. Black and Hispanic women have a higher rate of stroke than white women.
  7. There are several sex specific risk factors for women and stroke:
    i. Pregnancy
    ii. Preeclampsia
    iii. Gestational diabetes
    iv. Oral contraceptive use
    v. Postmenopausal hormone use
    vi. Changes in hormonal status
  8. There are several risk factors that are more strongly prevalent in women:
    i. Migraine with aura
    ii. Atrial fibrillation
    iii. Diabetes mellitus
    iv. Hypertension
    v. Depression
    vi. Psychosocial stress
  9. This guideline discusses hormone replacement therapy in relationship to primary prevention and in those women who already have cardiovascular disease and stroke.
  10. It is recommended that women be screened for a history of pregnancy risk factors such as preeclampsia and this should be documented as a risk factor for stroke.


Bushnell C, McCullough LD, Awad IA, Chireau MV, Fedder WN, Furie KL, Howard VJ, Lichtman JH, Lisabeth LD, Piña IL, Reeves MJ, Rexrode KM, Saposnik G, Singh V, Towfighi A, Vaccarino V, Walters MR; on behalf of the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Council for High Blood Pressure Research. Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association. [published online ahead of print February 6, 2014]. Stroke. doi: 10.1161/01.str.0000442009.06663.48.